US8317717B2 - Method and apparatus for third heart sound detection - Google Patents
Method and apparatus for third heart sound detection Download PDFInfo
- Publication number
- US8317717B2 US8317717B2 US12/283,760 US28376008A US8317717B2 US 8317717 B2 US8317717 B2 US 8317717B2 US 28376008 A US28376008 A US 28376008A US 8317717 B2 US8317717 B2 US 8317717B2
- Authority
- US
- United States
- Prior art keywords
- threshold
- window
- heart
- acoustic signal
- acoustic
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active, expires
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
- A61B7/02—Stethoscopes
- A61B7/04—Electric stethoscopes
Landscapes
- Physics & Mathematics (AREA)
- Acoustics & Sound (AREA)
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Electrotherapy Devices (AREA)
Abstract
A cardiac rhythm management system includes a heart sound detector providing for detection of the third heart sounds (S3). An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including the second heart sounds (S2) and S3. The heart sound detector detects occurrences of S2 and starts S3 detection windows each after a predetermined delay after a detected occurrence of S2. The occurrences of S3 are then detected from the acoustic signal within the S3 detection windows.
Description
This application is a continuation of U.S. patent application Ser. No. 10/746,853, filed Dec. 24, 2003, now issued as U.S. Pat. No. 7,431,699, which is hereby incorporated by reference in its entirety.
This application is related to commonly assigned U.S. patent application Ser. No. 10/746,874, entitled “A THIRD HEART SOUND ACTIVITY INDEX FOR HEART FAILURE MONITORING,” filed on Dec. 24, 2003, now U.S. Pat. No. 7,115,096, U.S. patent application Ser. No. 10/334,694, entitled “METHOD AND APPARATUS FOR MONITORING OF DIASTOLIC HEMODYNAMICS,” filed Dec. 30, 2002, now issued as U.S. Pat. No. 7,972,275, and U.S. patent application Ser. No. 10/307,896, “PHONOCARDIOGRAPHIC IMAGE-BASED ATRIOVENTRICULAR DELAY OPTIMIZATION,” filed Dec. 12, 2002, now issued as U.S. Pat. No. 7,123,962, all assigned to Cardiac Pacemakers, Inc., which are hereby incorporated by reference in their entirety.
This document relates generally to cardiac rhythm management systems and particularly, but not by way of limitation, to such a system sensing and analyzing heart sounds for monitoring, diagnosis, and therapy control.
The heart is the center of a person's circulatory system. It includes a complex electromechanical system performing two major pumping functions. The left portions of the heart draw oxygenated blood from the lungs and pump it to the organs of the body to provide the organs with their metabolic needs for oxygen. The right portions of the heart draw deoxygenated blood from the organs and pump it into the lungs where the blood gets oxygenated. These mechanical pumping functions are accomplished by contractions of the myocardium (heart muscles). In a normal heart, the sinoatrial (SA) node, the heart's natural pacemaker, generates electrical impulses, called action potentials, that propagate through an electrical conduction system to various regions of the heart to excite myocardial tissues in these regions. Coordinated delays in the propagations of the action potentials in a normal electrical conduction system cause the muscles in various regions of the heart to contract in synchrony such that the pumping functions are performed efficiently. The normal pumping functions of the heart, or the normal hemodynamic performance, require a normal electrical system to generate the action potentials and deliver them to designated portions of the myocardium with proper timing, a normal myocardium capable of contracting with sufficient strength, and a normal electromechanical association such that all regions of the heart are excitable by the action potentials.
Electrocardiography (ECG) is known to indicate the functions of the electrical system by allowing monitoring of the action potentials at various portions of the heart. Heart sounds, or generally energies resulted from the heart's mechanical vibrations, indicate the heart's mechanical activities. Measurements performed with simultaneously recorded ECG and heart sounds provide for quantitative indications of the electromechanical association.
One type of heart sound, known as the third heart sound, or S3, is known as an indication of heart failure. A heart failure patient suffers from an abnormal electrical conduction system with excessive conduction delays and deteriorated heart muscles that result in asynchronous and weak heart contraction, and hence, reduced pumping efficiency, or poor hemodynamic performance. While the ECG of a heart failure patient may show excessive delays and/or blockages in portions of the electrical conduction system, S3 indicates his or her heart's abnormal mechanical functions. For example, an increase in S3 activity is known to be an indication of elevated filing pressures, which may result in a state of decompensated heart failure. Additionally, S3 amplitude is also related to filing pressures of the left ventricle during diastole. The pitch, or fundamental frequency, of S3 is related to ventricular stiffness and dimension. Chronic changes in S3 amplitude are correlated to left ventricular chamber stiffness and degree of restrictive filling. Such parameters indicate abnormal cardiac conditions, including degrees of severity, and need of appropriate therapies.
For these and other reasons, there is a need for a system providing for S3 detection and analysis.
A cardiac rhythm management system includes a heart sound detector providing for detection of the third heart sounds (S3). An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including the second heart sounds (S2) and S3. The heart sound detector detects occurrences of S2 and starts S3 detection windows each after a predetermined delay after a detected occurrence of S2. The occurrences of S3 are then detected from the acoustic signal within the S3 detection windows.
In one embodiment, a heart sound detection system includes a cardiac signal input, an acoustic signal input, and a heart sound detector. The cardiac signal input receives a cardiac signal indicative of ventricular events. The acoustic signal input receives an acoustic signal indicative of at least S2 and S3. The heart sound detector includes an S2 window generator, an S2 detector, an S3 window generator, and an S3 detector. The S2 window generator generates an S2 window after a predetermined delay starting with each of the ventricular events. The S2 detector detects S2 during the S2 windows. The S3 window generator generates an S3 window after a predetermined delay starting with each of the detected S2. The S3 detector detects S3 during the S3 windows.
In one embodiment, a heart sound detection method provides for S3 detection. A cardiac signal indicative of ventricular events and an acoustic signal indicative of at least S2 and S3 are received. S2 are detected by comparing the acoustic signal to an S2 threshold. An S3 window is generated after a first predetermined delay starting with each of the detected S2. S3 are detected during the S3 window by comparing the acoustic signal to a dynamically adjustable S3 threshold.
In one embodiment, an implantable cardiac rhythm management system includes an implantable lead, an implantable acoustic sensor, and an implantable medical device. The implantable lead is used for sensing a cardiac signal indicative of ventricular events. The implantable acoustic sensor is used to sense an acoustic signal indicative of at least S2 and S3. The implantable medical device includes a cardiac signal input to receive the cardiac signal, an acoustic signal input to receive the acoustic signal, and a heart sound detector to detect S2 and S3. The heart sound detector includes an S2 window generator, an S2 detector, an S3 window generator, and an S3 detector. The S2 window generator generates an S2 window after a predetermined delay starting with each of the ventricular events. The S2 detector detects S2 during the S2 windows. The S3 window generator generate an S3 window after another predetermined delay starting with each of the detected S2. The S3 detector to detect S3 during the S3 windows.
This Summary is an overview of some of the teachings of the present application and not intended to be an exclusive or exhaustive treatment of the present subject matter. Further details about the present subject matter are found in the detailed description and appended claims. Other aspects of the invention will be apparent to persons skilled in the art upon reading and understanding the following detailed description and viewing the drawings that form a part thereof, each of which are not to be taken in a limiting sense. The scope of the present invention is defined by the appended claims and their equivalents.
In the drawings, which are not necessarily drawn to scale, like numerals describe similar components throughout the several views. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that the embodiments may be combined, or that other embodiments may be utilized and that structural, logical and electrical changes may be made without departing from the spirit and scope of the present invention. The following detailed description provides examples, and the scope of the present invention is defined by the appended claims and their equivalents.
It should be noted that references to “an”, “one”, or “various” embodiments in this disclosure are not necessarily to the same embodiment, and such references contemplate more than one embodiment.
This document discusses, among other things, a cardiac rhythm management system monitoring and analyzing heart sounds, particularly the third heart sounds (S3), that are indicative of a heart's mechanical events related to the heart's pumping functions and hemodynamic performance to allow, among other things, diagnosis of cardiac conditions and selection of therapies treating the cardiac conditions. The cardiac rhythm management systems include systems having, for example, pacemakers, cardioverter/defibrillators, pacemaker/defibrillators, cardiac resynchronization therapy (CRT) devices, and cardiac remodeling control devices. However, it is to be understood that the present methods and apparatuses may be employed in other types of medical devices, including, but not being limited to, drug delivery systems and various types of cardiac monitoring devices.
More particularly, the cardiac rhythm management system discussed in this document generates and trends an S3 index indicative of S3 activity. The S3 index (or prevalence) is a ratio of the number of heart beats during which S3 are detected (“S3 beats”) to the number of all the heart beats. Because the S3 activity varies throughout the day, the S3 beats are counted for a plurality of measurement sessions distributed over a measurement period. The S3 index is then calculated for the measurement period and trended over multiple measurement periods. A trend of the S3 index provides for an indication of heart failure. For example, an increase in the trend of the S3 index may be indicative of abnormally restrictive filling and elevated filling pressures that lead to edema.
While this document particularly relates to S3, other hearts sounds are also detected and/or analyzed for S3 detection and other purposes. Known and studied heart sounds include the “first heart sound” or S1, the “second heart sound” or S2, the “third heart sound” or S3, the “fourth heart sound” or S4, and their various sub-components. S1 is known to be indicative of, among other things, mitral valve closure, tricuspid valve closure, and aortic valve opening. S2 is known to be indicative of, among other things, aortic valve closure and pulmonary valve closure. S3 is known to be a ventricular diastolic filling sound often indicative of certain pathological conditions including heart failure. S4 is known to be a ventricular diastolic filling sound resulted from atrial contraction and is usually indicative of pathological conditions. The term “heart sound” hereinafter refers to any heart sound (e.g., S1) and any components thereof (e.g., M1 component of S1, indicative of Mitral valve closure).
Throughout this document, “heart sound” includes audible and inaudible mechanical vibrations caused by cardiac activity that can be sensed with an accelerometer. Accordingly, when a mechanical sensor such as an accelerometer is used to sense the heart sounds, the scope of energy included in the sensed “acoustic signal” extends to energies associated with such mechanical vibrations. Unless noted otherwise, S1 refers to the first heart sound, S2 refers to the second heart sound, S3 refers to the third heart sound, and S4 refers to the fourth heart sounds, each as a heart sound type, or as one or more occurrences of the corresponding type heart sounds, depending on the context. A “heart beat” includes a cardiac cycle. An “S3 beat” includes a cardiac cycle during which S3 is detected. An “S3 index,” also referred to as an “S3 ratio,” includes a ratio of the number of the S3 beats to the number of the total heart hearts, both detected during the same time period.
Throughout this document, a “user” includes a physician or other caregiver who examines and/or treats a patient using one or more of the methods and apparatuses reported in the present document.
Beat counter 103 counts the number of detected heart beats. In one embodiment, beat counter 103 counts one beat for each intrinsic or paced ventricular event.
Heart sound counter 106 counts the number of S3 beats. During each counted heart beat, if heart sound detector 105 detects an S3, heart sound counter 106 counts one S3 beat.
S2 and S3 detections are repeated for each cardiac cycle when the heart sounds are being detected. S2 detection includes comparing the amplitude of acoustic signal 340 to S2 threshold 346 during an S2 window 354. S2 window has a predetermined temporal relationship with a ventricular (V) event detection 349, such as an R-wave or a delivery of a ventricular pacing pulse. As illustrated in FIG. 3 , V event detection 349 starts a predetermined S2 window delay 355. S2 window 354 starts when S2 window delay 355 expires. S2 detection occurs when the amplitude of acoustic signal 340 exceeds S2 threshold 346 during S2 window 354. S2 window delay 355 and the duration of S2 window 354 are programmed on a patient-by-patient basis. In one embodiment, the timing of S2 detection 350 is empirically estimated for each individual patient and dynamically adjusted based on the patient's heart rate. In one specific example, the time interval between V event detection 349 and S2 detection 350, TV-S2, is estimated by: TV-S2=0.500−0.002 HR seconds, where HR is heart rate in beats per minute, and 0.500 seconds is empirically derived for the individual patient. Then, the duration of S2 window 354 is empirically derived for that patient, and S2 window 354 is centered at the estimated time for S2 detection 350, i.e., end of TV-S2. S2 window delay is, therefore, TV-S2 minus a half of the duration of S2 window 354.
S3 detection includes comparing the amplitude of acoustic signal 340 to S3 threshold 347 during an S3 window 356. S3 window has a predetermined temporal relationship with S2 detection 350. An S3 window delay 357 starts with S2 detection 350. S3 window 356 starts when S3 window delay 357 expires. S3 detection occurs when the amplitude of acoustic signal 340 exceeds S3 threshold 347 during S3 window 356. S3 window delay 357 and the duration of S3 window 356 are programmed on a patient-by-patient basis. In one embodiment, S3 window delay 357 is programmable between 100 and 200 milliseconds. The duration of S3 window 356 is programmable to about 150 ms but is terminated by V event 349 of the next cardiac cycle it occurs before the end of the programmed duration.
As illustrated in FIG. 2 , heart sound detector 105 includes a heart rate detector 220, an S1 detector 222, an S2 detection module (including an S2 detection preparation module, an S2 window generator 225, an S2 threshold generator 226, and an S2 detector 227), an S3 detection module (including an S3 detection preparation module, an S3 window generator 230, an S3 threshold generator 231, and an S3 detector 232), and a measurement module 234. Heart rate detector 220 detects a heart rate from the cardiac signal such as the signal received by cardiac signal input 101.
S1 detector is required when S3 threshold 347 depends at least partially on the S1 amplitude or energy. It is also required when, as part of an overall signal processing and analysis scheme, measurement related to S1 are taken.
S2 detection preparation module 224, S2 window generator 225, S2 threshold generator 226, and S2 detector 227 perform S2 detection. S2 detection preparation module 224 is needed when acoustic signal 340 needs to be further processed to facilitate an accurate S2 detection. In one embodiment, S2 detection preparation module 224 includes an averaging circuit that improves the signal-to-noise ratio of acoustic signal 340 by ensemble averaging. In one specific embodiment, the averaging circuit aligns multiple segments of acoustic signal 340 by V event markers representing V event detection 349 on each segment. The segments of acoustic signal 340 to be included for the ensemble averaging are selected from segments of acoustic signal 340 associated with consecutive cardiac cycles with a relatively constant heart rate (e.g., within about 10 to 20 beats per minute variation). S2 window generator 225 includes an S2 window delay timer to time S2 window delay 355 and an S2 window timer to time S2 window 354. V event detection 349 (represented by such as an event marker include in the cardiac signal) triggers the S2 window delay timer to start timing S2 window delay 355. The expiration of S2 window delay 355 triggers the S2 window timer to time S2 window 354, during which S2 is being detected. S2 threshold generator 226 generates S2 threshold 346 based on the amplitude of S1 and/or the amplitude of S2. In one embodiment, S2 threshold generator 226 dynamically adjusts S2 threshold 346 based on the amplitude of S1 and/or the amplitude of S2 averaged over a moving window including a plurality of heart beats. S2 detector 227 includes a comparator to compare acoustic signal 340 to S2 threshold 346, and detects an occurrence of S2 when the amplitude of acoustic signal 340 exceeds S2 threshold 346 during S2 window 354.
S3 detection preparation module 229, S3 window generator 230, S3 threshold generator 231, and S3 detector 232 perform the S3 detection. S3 detection preparation module 229 is needed when acoustic signal 340 needs to be further processed to facilitate an accurate S3 detection. In one embodiment, S3 detection preparation module 229 includes the averaging circuit of S2 detection preparation module 224, and the averaged acoustic signal is used for both S2 and S3 detection. In one specific embodiment, S3 detection preparation module 229 and S2 detection preparation module 224 includes a single averaging circuit—the same averaging circuit that performs the ensemble averaging discussed above. In another embodiment, S3 detection preparation module 229 includes an averaging circuit for the purpose of S3 detection only. This averaging circuit improves the signal-to-noise ratio of acoustic signal 340 for the S3 detection by an ensemble averaging process. The averaging circuit aligns multiple segments of acoustic signal 340 by S2 markers representing S2 detection 350 on each segment, where the S2 detection 350 is resulted from S2 detection performed on acoustic signal 340 before the ensemble averaging. The segments of acoustic signal 340 to be included for the ensemble averaging are selected from segments of acoustic signal 340 associated with consecutive cardiac cycles with a relatively constant heart rate (e.g., within about 10 to 20 beats per minute variation). S3 window generator 230 includes an S3 window delay timer to time S3 window delay 357 and an S2 window timer to time S3 window 356. S3 detection 350 triggers the S3 window delay timer to start timing S3 window delay 357. The expiration of S3 window delay 357 triggers the S3 window timer to time S3 window 356, during which S3 is being detected. S3 threshold generator 231 generates S3 threshold 347. In one embodiment, S3 threshold generator 231 determines S3 threshold 347 based on one or more of an S1 amplitude and an S2 amplitude. In one specific embodiment, S3 threshold generator 231 determines S3 threshold 347 as a percentage of the S2 amplitude. In another embodiment, S3 threshold generator 231 determines S3 threshold 347 based on a total acoustic energy in one cardiac cycle. The purpose is to normalize S3 threshold 347 by the total acoustic energy, such that the S3 detection remains accurate when external variables causes the amplitude of acoustic signal 340 to shift. The total acoustic energy is calculated by integrating acoustic signal 340 over one cardiac cycle or adding the estimated energies of S1, S2, and S3 (if present). In one specific example, S3 threshold generator 231 determines S3 threshold 347 based on at least a mean and a standard deviation of the total acoustic energy in the cardiac cycle. In another embodiment, S3 threshold generator 231 determines S3 threshold 347 based on a total acoustic energy during systole of one cardiac cycle. The total acoustic energy is calculated by integrating acoustic signal 340 over the time interval between V event detection 349 and the beginning of S3 window 356 or adding the estimated energies of S1 and S2. In one specific embodiment, S3 threshold generator 231 determines S3 threshold 347 based on at least a mean and a standard deviation of the total acoustic energy during systole of the cardiac cycle. In another embodiment, S3 threshold generator 231 determines S3 threshold 347 based on a temporal average of one or more of the S1 amplitude, the S2 amplitude, and the total acoustic energy in one cardiac cycle. In another embodiment, S3 threshold generator 231 determines S3 threshold 347 based on an estimated background sound level 345 (μB) measured during a background estimate period 353, which is a predetermined period between S1 and S2, as illustrated in FIG. 3 . Background estimate period 353 is centered between TS1max and TS2min, where TS1max is the latest point in time where S1 energy is expected, and is TS2min is the point in time where S2 window 354 begins. In one embodiment, TS1max is empirically estimated based on a patient population. In one embodiment, TS1max is in a range of about 100 to 200 millisecond after V event detection 349. In one embodiment, the duration of background estimate period 353 substantially equals to the time interval between TS1max and TS2min. In another embodiment, the duration of background estimate period 353 is shorter than the time interval between TS1max and TS2min. In another embodiment, the duration of background estimate period 353 is set to be equal to the time interval between TS1max and TS2min but subjected to a maximum duration and a minimum duration. The duration of background estimate period 353 is set to the maximum duration if the time interval between TS1max and TS2min is longer than the maximum duration and to the minimum duration if the time interval between TS1max and TS2min is shorter than the minimum duration. In one embodiment, S3 threshold generator 231 scales background estimate period 353 for the detected heart rate. S3 threshold 347 is a function of μB. In one specific embodiment, S3 threshold generator 231 sets and dynamically adjusts S3 threshold 347 to μB*K, where K is a programmable constant. In one embodiment, K is a constant determined, and can be later adjusted, by a user. In one embodiment, K is a constant false alarm rate (CFAR) as known in the art of signal processing. S3 detector 232 includes a comparator to compare acoustic signal 340 to S3 threshold 347, and detects an occurrence of S3 when the amplitude of acoustic signal 340 exceeds S3 threshold 347 during S3 window 356.
Cardiac and acoustic signals required for trending the S3 index are sensed and preprocessed at 400. At 402, an acoustic signal is sensed. In one embodiment, this includes sensing an audio signal generated from a heart using a microphone placed in or near the heart. In another embodiment, this includes sensing a mechanical vibration of the heart using an accelerometer placed in or near the heart. The acoustic signal is preprocessed at 404. In one embodiment, this includes performing envelope detection, i.e., rectifying and low-pass filtering the sensed acoustic signal. One example of a resultant preprocessed acoustic signal is illustrated as acoustic signal 340 in FIG. 3 . At 406, at least one electrogram is sensed. In one embodiment, this includes sensing a ventricular electrogram with at least one electrode placed a ventricular chamber of the heart to sense ventricular events. A cardiac signal is produced at 408. In one embodiment, this includes detecting cardiac events indicated in the sensed electrogram and producing event markers each indicative of an occurrence of the detected cardiac events, including its type and timing. In one specific example, the cardiac signal includes ventricular event markers representing sensed ventricular contractions and/or deliveries of ventricular pacing pulses.
The heart sound analysis producing the trend of the S3 index is a periodic process timed at 420. The timing includes timing measurement periods each including a plurality of measurement sessions. In one embodiment, the measurement period is a predetermined time period defined as a number of hours, days, weeks, etc. Each measurement period includes a plurality of prescheduled measurement sessions. In one embodiment, a physical activity level is detected at 422. The physical activity level indicates a person's gross bodily movements that may interfere with the sensing of the acoustic signal. A permission signal is issued at 424 to allow the start of a measurement session if the physical activity level is below a threshold level indicating that the person is resting. If the permission signal is present when a measurement session is scheduled to begin, a measurement session is timed at 426. In one embodiment, the measurement session is timed as a predetermined period of time. In another embodiment, the measurement session is timed by counting a predetermined number of heart beats. If the permission signal is absent when a measurement session is scheduled to begin, the measurement session is postponed for a predetermined period of time or until the physical activity level falls below the threshold level. In one embodiment, timing S3 index trending at 420 also includes timing the acquisition of the cardiac and acoustic signals.
A trend of the S3 index is produced at 440. The cardiac signal produced at 408 and the acoustic signal preprocessed at 404 are received at 442. Heart beats are counted at 444 for each measurement session or period, based on one type of cardiac events included in the cardiac signal. In one embodiment, one heart beat is counted for each ventricular event. Occurrences of S3 are detected at 446. The S3 beats are counted at 448 for each measurement session or period. The S3 index is calculated at 450, as the ratio of the number of S3 beats to the number of total heart beats counted during the measurement session or period. In one embodiment, the ratio is expressed as a percentage. The trend of the S3 index is produced at 452. In one embodiment, the trend of the S3 index is a moving S3 index calculated for the measurement periods. In another embodiment, the trend of the S3 index is a moving average of the S3 index calculated for the measurement sessions over the measurement periods. In one embodiment, trend of the S3 index is presented as a plot of S3 indices over a measured period or another predetermined period. In one specific embodiment, trend of the S3 index is presented as a plot of daily S3 indices.
Cardiac and acoustic signals are sensed and preprocessed at 500. At 502, an acoustic signal is sensed. In one embodiment, this includes sensing an audio signal generated from a heart using a microphone placed in or near the heart. In another embodiment, this includes sensing a mechanical vibration of the heart using an accelerometer placed in or near the heart. The acoustic signal is envelope-detected, i.e., rectified and low-pass filtered, at 504. One example of the envelope-detected acoustic signal is illustrated as acoustic signal 340 in FIG. 3 . At 506, a ventricular electrogram is sensed. A cardiac signal is produced at 508. This includes detecting ventricular events, including sensed ventricular contractions and/or deliveries of ventricular pacing pulses, and generating ventricular event markers representing the detected ventricular events. In one embodiment, when the S3 index trending method (illustrated in FIG. 4 ) employs the S3 detection method (illustrated in FIG. 5 ), step 400 and step 500 include substantially the same steps.
Heart sounds including S1, S2, and/or S3 are detected at 520. The cardiac signal and the acoustic signal are received at 522. S1 is detected at 524. In one embodiment, detecting S1 includes comparing the amplitude of the preprocessed acoustic signal to an S1 threshold. An S2 window is generated at 526. An S2 threshold is determined at 528. S2 is detected at 530. In one embodiment, steps 526, 528, and 530 are performed using the method discussed above with reference to FIG. 3 . An S3 window is generated at 532. An S3 threshold is determined at 534. S3 is detected at 536. In one embodiment, steps 532, 534, and 536 are performed using the method discussed above with reference to FIG. 3 .
Parameters are measured from the detected heart sounds at 550. In one embodiment, the parameters are used to determine the S1 threshold, the S2 threshold, and/or the S3 threshold. Amplitudes of S1, S2, and/or S3 are measured at 552. In one embodiment, each amplitude is measured as an average of amplitudes of one type heart sound measured over a plurality of heart beats. Energies associated with S1, S2, and/or S3 are measured at 554. In one embodiment, each energy is measured as an average of energies associated with one type heart sound measured over a plurality of heart beats. A total acoustic energy during a cardiac cycle is measured (and/or calculated) at 556. In one embodiment, the total acoustic energy during the cardiac cycle is measured as an average over a plurality of cardiac cycles (heart beats). A total acoustic energy during systole is measured (and/or calculated) at 558. In one embodiment, the total acoustic energy during systole is measured as an average over a plurality of heart beats.
In one embodiment, one or more parameters measured at 550 are used for analyzing cardiac conditions. One example of such parameter measurement and use is discussed in U.S. patent application Ser. No. 10/334,694, entitled “METHOD AND APPARATUS FOR MONITORING OF DIASTOLIC HEMODYNAMICS,” filed Dec. 30, 2002, assigned to Cardiac Pacemakers, Inc., the specification of which is incorporated herein by reference in its entirety.
In one embodiment, external system 670 includes an external device 671 in proximity of implantable device 667, a remote device 673 in a relatively distant location, and a telecommunication system 672 linking external device 671 and remote device 673. An example of such an external system includes an advanced patient management system discussed in U.S. patent application Ser. No. 10/323,604, entitled “ADVANCED PATIENT MANAGEMENT FOR DEFINING, IDENTIFYING AND USING PREDETERMINED HEALTH-RELATED EVENTS,” filed on Dec. 18, 2002, published as US 20040122484, assigned to Cardiac Pacemakers, Inc., the specification of which is incorporated herein by reference in its entirety. In another embodiment, external system 670 includes an implantable medical device programmer.
In one embodiment, telemetry link 669 is an inductive telemetry link. In an alternative embodiment, telemetry link 669 is a far-field radio-frequency telemetry link. In one embodiment, telemetry link 669 provides for data transmission from implantable device 667 to external device 671. This may include, for example, transmitting real-time physiological data acquired by implantable device 667, extracting physiological data acquired by and stored in implantable device 667, extracting therapy history data stored in implantable device 667, and extracting data indicating an operational status of implantable device 667 (e.g., battery status and lead impedance). In a further embodiment, telemetry link 669 provides for data transmission from external device 671 to implantable device 667. This may include, for example, programming implantable device 667 to acquire physiological data, programming implantable device 667 to perform at least one self-diagnostic test (such as for a device operational status), and programming implantable device 667 to deliver at least one therapy.
In one embodiment, programming implantable device 667 includes sending therapy parameters to implantable device 667. The therapy parameters provide an improved hemodynamic performance for a patient by delivering cardiac pacing pulses to the patient's heart. In one embodiment, the therapy parameters providing for the improved hemodynamic performance are determined by monitoring one or more ventricular diastolic hemodynamics as indicated by parameters related to heart sounds. Such parameters indicate the heart's mechanical activities and electromechanical association. In one specific embodiment, the parameters related to heart sounds are measured by heart sound processing system 100, as discussed above with reference to FIGS. 1-3 .
In one embodiment, in addition to the functions of external heart sound processor 790, external heart sound module 778 analyzes parameters derived from detected cardiac events and heart sounds. Examples of such analyses are discussed in U.S. patent application Ser. No. 10/307,896, “PHONOCARDIOGRAPHIC IMAGE-BASED ATRIOVENTRICULAR DELAY OPTIMIZATION.” filed Dec. 12, 2002, and U.S. patent application Ser. No. 10/334,694, entitled “METHOD AND APPARATUS FOR MONITORING OF DIASTOLIC HEMODYNAMICS,” filed Dec. 30, 2002, now issued as U.S. Pat. No. 7,972,275 both assigned to Cardiac Pacemakers, Inc., the specifications of which are incorporated herein by reference in their entirety.
It is to be understood that the above detailed description is intended to be illustrative, and not restrictive. For example, heart sound processing system 100 may be incorporated into any implanted or external medical device providing for ECG and heart sound monitoring. Other embodiments will be apparent to those of skill in the art upon reading and understanding the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
Claims (28)
1. A heart sound detection system, comprising:
an acoustic signal input adapted to receive an acoustic signal indicative of heart sounds including second heart sounds (S2) and third heart sounds (S3); and
a heart sound detector coupled to the acoustic signal input, the heart sound detector including:
an S2 detector adapted to detect S2 using the acoustic signal;
an S3 window generator adapted to generate an S3 window in response to each detection of S2;
an S3 detector adapted to detect S3 using the acoustic signal and an S3 threshold during the S3 windows;
a measurement module adapted to detect an acoustic energy using the acoustic signal; and
an S3 threshold generator adapted to determine the S3 threshold using the acoustic energy, wherein the S3 threshold generator is adapted to normalize the S3 threshold using the acoustic energy.
2. The system of claim 1 , wherein the S3 window generator is adapted to generate the S3 window after a programmed delay starting with each of the detected S2.
3. The system of claim 2 , wherein the measurement module is adapted to detect a total acoustic energy during a cardiac cycle, and the S3 threshold generator is adapted to dynamically adjust the S3 threshold using the total acoustic energy detected during the cardiac cycle.
4. The system of claim 3 , wherein the S3 threshold generator is adapted to dynamically adjust the S3 threshold using a mean and a standard deviation of the total acoustic energy during the cardiac cycle.
5. The system of claim 2 , wherein the measurement module is adapted to detect a total acoustic energy during systole of a cardiac cycle, and the S3 threshold generator is adapted to dynamically adjust the S3 threshold using the total acoustic energy during systole of the cardiac cycle.
6. The system of claim 5 , wherein the S3 threshold generator is adapted to dynamically adjust the S3 threshold using a mean and a standard deviation of the total acoustic energy during the systole of the cardiac cycle.
7. A heart sound detection method, comprising:
receiving an acoustic signal indicative of heart sounds including second heart sounds (S2) and third heard sounds (S3);
detecting S2 using the acoustic signal;
generating an S3 window following each of the detected S2;
detecting S3 during the S3 windows by comparing the acoustic signal to an S3 threshold;
detecting an acoustic energy using the acoustic signal; and
dynamically adjusting the S3 threshold using the acoustic energy, including normalizing the S3 threshold using the acoustic energy.
8. The method of claim 7 , wherein generating the S3 window comprises generating the S3 window after a programmed delay starting with each of the detected S2.
9. The method of claim 8 , comprising:
receiving a cardiac signal indicative of ventricular events;
detecting ventricular events from the cardiac signal; and
terminating the S3 window if one of the ventricular events occurs during the S3 window.
10. The method of claim 8 , comprising determining the S3 threshold using at least a mean and a standard deviation of the acoustic energy.
11. The method of claim 8 , wherein detecting the acoustic energy comprises detecting a total acoustic energy during a cardiac cycle as the acoustic energy.
12. The method of claim 8 , wherein detecting the acoustic energy comprises detecting a total acoustic energy during systole of a cardiac cycle as the acoustic energy.
13. A heart sound detection system, comprising:
an acoustic signal input to receive an acoustic signal indicative of heart sounds including first heart sounds (S1), second heart sounds (S2), and third heart sounds (S3); and
a heart sound detector coupled to the acoustic signal input, the heart sound detector including:
an S2 detector adapted to detect S2 using the acoustic signal;
an S3 detection preparation module adapted to align segments of the acoustic signal using the detected S2 and ensemble average the acoustic signal using the aligned segments;
an S3 window generator adapted to generate an S3 window in response to each detection of S2;
an S3 detector adapted to detect S3 during the S3 windows using the averaged acoustic signal and an S3 threshold; and
an S3 threshold generator adapted to determine the S3 threshold using an estimated background sound level (μB) measured during a period between an occurrence of S1 and an adjacent occurrence of S2.
14. The system of claim 13 , wherein the S3 threshold generator is adapted to dynamically adjust the S3 threshold using μB.
15. The system of claim 14 , wherein the S3 threshold generator is adapted to calculate the S3 threshold as μB*K, where K is an adjustable multiplier.
16. The system of claim 15 , wherein the S3 threshold generator is adapted to scale the period between the occurrence of S1 and the adjacent occurrence of S2 for a heart rate.
17. The system of claim 16 , comprising:
a cardiac signal input adapted to receive a cardiac signal indicative of ventricular events; and
an S2 window generator adapted to generate an S2 window in response to the detection of each of the ventricular events, and wherein the S2 detector is adapted to detect S2 during the S2 windows.
18. The system of claim 17 , wherein the S3 window generator is adapted to generate the S3 window after a second programmed delay starting with each of the detected S2.
19. The system of claim 13 , wherein the S3 threshold generator is adapted to determine the S3 threshold using the μB measured during a period set to be substantially equal to a time interval between a latest point in time where S1 energy is expected and a point in time where the S2 window begins and to be subjected to a maximum duration and a minimum duration.
20. The system of claim 13 , wherein the S3 threshold generator is adapted to dynamically adjusting the S3 threshold using the μB measured during a period centered between a latest point in time where S1 energy is expected and a point in time where the S2 window begins, wherein the latest point in time where S1 energy is expected is empirically estimated based on a patient population.
21. A heart sound detection method, comprising:
receiving an acoustic signal indicative of heart sounds including first heart sounds (S1), second heart sounds (S2), and third heart sounds (S3);
detecting S2 using the acoustic signal;
aligning segments of the acoustic signal using the detected S2;
ensemble averaging the acoustic signal using the aligned segments;
generating an S3 window following each of the detected S2;
detecting S3 during the S3 windows by comparing the ensemble averaged acoustic signal to a dynamically adjustable S3 threshold; and
dynamically adjusting the S3 threshold using an estimated background sound level (μB) measured during a period between an occurrence of S1 and an adjacent occurrence of S2.
22. The method of claim 21 , wherein dynamically adjusting the S3 threshold comprises calculating the S3 threshold as μB*K, where K is an adjustable.
23. The method of claim 22 , comprising:
receiving a cardiac signal indicative of ventricular events;
detecting a heart rate using the cardiac signal; and
scaling the period between the occurrence of S1 and the adjacent occurrence of S2 for the heart rate.
24. The method of claim 23 , comprising:
detecting ventricular events from the cardiac signal; and
terminating the S3 window if one of the ventricular events occurs during the S3 window.
25. The method of claim 21 , comprising:
receiving a cardiac signal indicative of ventricular events; and
generating an S2 window in response to the detection of each of the ventricular events,
and wherein detecting S2 comprises detecting S2 during the S2 windows.
26. The method of claim 25 , wherein generating the S3 window comprises generating the S3 window after a programmed delay starting with each of the detected S2.
27. The method of claim 21 , wherein dynamically adjusting the S3 threshold comprises dynamically adjusting the S3 threshold using the μB measured during a period set to be substantially equal to a time interval between a latest point in time where S1 energy is expected and a point in time where the S2 window begins and to be subjected to a maximum duration and a minimum duration.
28. The system of claim 21 , wherein dynamically adjusting the S3 threshold comprises:
dynamically adjusting the S3 threshold using the measured during a period centered between a latest point in time where S1 energy is expected and a point in time where the S2 window begins; and
estimating the latest point in time where S1 energy is expected empirically based on a patient population.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/283,760 US8317717B2 (en) | 2003-12-24 | 2008-09-16 | Method and apparatus for third heart sound detection |
US13/685,170 US8827919B2 (en) | 2003-12-24 | 2012-11-26 | Method and apparatus for third heart sound detection |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/746,853 US7431699B2 (en) | 2003-12-24 | 2003-12-24 | Method and apparatus for third heart sound detection |
US12/283,760 US8317717B2 (en) | 2003-12-24 | 2008-09-16 | Method and apparatus for third heart sound detection |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/746,853 Continuation US7431699B2 (en) | 2003-12-24 | 2003-12-24 | Method and apparatus for third heart sound detection |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/685,170 Continuation US8827919B2 (en) | 2003-12-24 | 2012-11-26 | Method and apparatus for third heart sound detection |
Publications (2)
Publication Number | Publication Date |
---|---|
US20090018461A1 US20090018461A1 (en) | 2009-01-15 |
US8317717B2 true US8317717B2 (en) | 2012-11-27 |
Family
ID=34710746
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/746,853 Active 2025-10-08 US7431699B2 (en) | 2003-12-24 | 2003-12-24 | Method and apparatus for third heart sound detection |
US12/283,760 Active 2026-10-30 US8317717B2 (en) | 2003-12-24 | 2008-09-16 | Method and apparatus for third heart sound detection |
US13/685,170 Expired - Lifetime US8827919B2 (en) | 2003-12-24 | 2012-11-26 | Method and apparatus for third heart sound detection |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/746,853 Active 2025-10-08 US7431699B2 (en) | 2003-12-24 | 2003-12-24 | Method and apparatus for third heart sound detection |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/685,170 Expired - Lifetime US8827919B2 (en) | 2003-12-24 | 2012-11-26 | Method and apparatus for third heart sound detection |
Country Status (1)
Country | Link |
---|---|
US (3) | US7431699B2 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20130085407A1 (en) * | 2003-12-24 | 2013-04-04 | Krzysztof Z. Siejko | Method and apparatus for third heart sound detection |
US20140031643A1 (en) * | 2012-07-27 | 2014-01-30 | Cardiac Pacemakers, Inc. | Heart failure patients stratification |
US9968266B2 (en) | 2006-12-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Risk stratification based heart failure detection algorithm |
US10123745B1 (en) | 2015-08-21 | 2018-11-13 | Greatbatch Ltd. | Apparatus and method for cardiac signal noise detection and disposition based on physiologic relevance |
US10405826B2 (en) | 2015-01-02 | 2019-09-10 | Cardiac Pacemakers, Inc. | Methods and system for tracking heart sounds |
US11615891B2 (en) | 2017-04-29 | 2023-03-28 | Cardiac Pacemakers, Inc. | Heart failure event rate assessment |
Families Citing this family (73)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20030036746A1 (en) | 2001-08-16 | 2003-02-20 | Avi Penner | Devices for intrabody delivery of molecules and systems and methods utilizing same |
US7468032B2 (en) | 2002-12-18 | 2008-12-23 | Cardiac Pacemakers, Inc. | Advanced patient management for identifying, displaying and assisting with correlating health-related data |
US8391989B2 (en) | 2002-12-18 | 2013-03-05 | Cardiac Pacemakers, Inc. | Advanced patient management for defining, identifying and using predetermined health-related events |
US20040122294A1 (en) | 2002-12-18 | 2004-06-24 | John Hatlestad | Advanced patient management with environmental data |
US7983759B2 (en) | 2002-12-18 | 2011-07-19 | Cardiac Pacemakers, Inc. | Advanced patient management for reporting multiple health-related parameters |
US20040122487A1 (en) | 2002-12-18 | 2004-06-24 | John Hatlestad | Advanced patient management with composite parameter indices |
US8043213B2 (en) | 2002-12-18 | 2011-10-25 | Cardiac Pacemakers, Inc. | Advanced patient management for triaging health-related data using color codes |
US7123962B2 (en) * | 2002-12-02 | 2006-10-17 | Cardiac Pacemakers, Inc. | Phonocardiographic image-based atrioventricular delay optimization |
US8951205B2 (en) | 2002-12-30 | 2015-02-10 | Cardiac Pacemakers, Inc. | Method and apparatus for detecting atrial filling pressure |
US7972275B2 (en) | 2002-12-30 | 2011-07-05 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring of diastolic hemodynamics |
US7378955B2 (en) * | 2003-01-03 | 2008-05-27 | Cardiac Pacemakers, Inc. | System and method for correlating biometric trends with a related temporal event |
US7248923B2 (en) * | 2003-11-06 | 2007-07-24 | Cardiac Pacemakers, Inc. | Dual-use sensor for rate responsive pacing and heart sound monitoring |
US9020595B2 (en) * | 2003-12-24 | 2015-04-28 | Cardiac Pacemakers, Inc. | Baroreflex activation therapy with conditional shut off |
US7873413B2 (en) * | 2006-07-24 | 2011-01-18 | Cardiac Pacemakers, Inc. | Closed loop neural stimulation synchronized to cardiac cycles |
US7115096B2 (en) | 2003-12-24 | 2006-10-03 | Cardiac Pacemakers, Inc. | Third heart sound activity index for heart failure monitoring |
US7209786B2 (en) | 2004-06-10 | 2007-04-24 | Cardiac Pacemakers, Inc. | Method and apparatus for optimization of cardiac resynchronization therapy using heart sounds |
US7480528B2 (en) * | 2004-07-23 | 2009-01-20 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US7559901B2 (en) * | 2004-07-28 | 2009-07-14 | Cardiac Pacemakers, Inc. | Determining a patient's posture from mechanical vibrations of the heart |
US8175705B2 (en) * | 2004-10-12 | 2012-05-08 | Cardiac Pacemakers, Inc. | System and method for sustained baroreflex stimulation |
EP1838210B1 (en) | 2004-11-24 | 2010-10-13 | Remon Medical Technologies Ltd. | Implantable medical device with integrated acoustic transducer |
US7662104B2 (en) | 2005-01-18 | 2010-02-16 | Cardiac Pacemakers, Inc. | Method for correction of posture dependence on heart sounds |
US8473049B2 (en) | 2005-05-25 | 2013-06-25 | Cardiac Pacemakers, Inc. | Implantable neural stimulator with mode switching |
US7542800B2 (en) * | 2005-04-05 | 2009-06-02 | Cardiac Pacemakers, Inc. | Method and apparatus for synchronizing neural stimulation to cardiac cycles |
US8406876B2 (en) * | 2005-04-05 | 2013-03-26 | Cardiac Pacemakers, Inc. | Closed loop neural stimulation synchronized to cardiac cycles |
US7493161B2 (en) | 2005-05-10 | 2009-02-17 | Cardiac Pacemakers, Inc. | System and method to deliver therapy in presence of another therapy |
US7424321B2 (en) * | 2005-05-24 | 2008-09-09 | Cardiac Pacemakers, Inc. | Systems and methods for multi-axis cardiac vibration measurements |
US7922669B2 (en) | 2005-06-08 | 2011-04-12 | Cardiac Pacemakers, Inc. | Ischemia detection using a heart sound sensor |
US7585279B2 (en) * | 2005-07-26 | 2009-09-08 | Cardiac Pacemakers, Inc. | Managing preload reserve by tracking the ventricular operating point with heart sounds |
US8585603B2 (en) * | 2005-08-03 | 2013-11-19 | Luca Longhini | Noninvasive apparatus and method for estimating blood pressure |
US7615012B2 (en) * | 2005-08-26 | 2009-11-10 | Cardiac Pacemakers, Inc. | Broadband acoustic sensor for an implantable medical device |
US7570998B2 (en) * | 2005-08-26 | 2009-08-04 | Cardiac Pacemakers, Inc. | Acoustic communication transducer in implantable medical device header |
CA2524507A1 (en) * | 2005-10-26 | 2007-04-26 | Coeurmetrics Inc | Multi-sensor high-resolution extraction of heart sounds |
US8108034B2 (en) | 2005-11-28 | 2012-01-31 | Cardiac Pacemakers, Inc. | Systems and methods for valvular regurgitation detection |
EP1962674A4 (en) * | 2005-12-16 | 2011-07-27 | St Jude Medical | Implantable medical device with condition detecting |
US7567836B2 (en) * | 2006-01-30 | 2009-07-28 | Cardiac Pacemakers, Inc. | ECG signal power vector detection of ischemia or infarction |
US7713213B2 (en) * | 2006-03-13 | 2010-05-11 | Cardiac Pacemakers, Inc. | Physiological event detection systems and methods |
US8920343B2 (en) | 2006-03-23 | 2014-12-30 | Michael Edward Sabatino | Apparatus for acquiring and processing of physiological auditory signals |
US7780606B2 (en) | 2006-03-29 | 2010-08-24 | Cardiac Pacemakers, Inc. | Hemodynamic stability assessment based on heart sounds |
US8005543B2 (en) | 2006-05-08 | 2011-08-23 | Cardiac Pacemakers, Inc. | Heart failure management system |
CN101090586B (en) * | 2006-06-16 | 2010-05-12 | 清华大学 | Nano flexible electrothermal material and heating device containing the nano flexible electrothermal material |
US8000780B2 (en) | 2006-06-27 | 2011-08-16 | Cardiac Pacemakers, Inc. | Detection of myocardial ischemia from the time sequence of implanted sensor measurements |
US7912548B2 (en) | 2006-07-21 | 2011-03-22 | Cardiac Pacemakers, Inc. | Resonant structures for implantable devices |
US7949396B2 (en) * | 2006-07-21 | 2011-05-24 | Cardiac Pacemakers, Inc. | Ultrasonic transducer for a metallic cavity implated medical device |
US8364263B2 (en) | 2006-10-26 | 2013-01-29 | Cardiac Pacemakers, Inc. | System and method for systolic interval analysis |
US20080119749A1 (en) | 2006-11-20 | 2008-05-22 | Cardiac Pacemakers, Inc. | Respiration-synchronized heart sound trending |
US8096954B2 (en) | 2006-11-29 | 2012-01-17 | Cardiac Pacemakers, Inc. | Adaptive sampling of heart sounds |
US7736319B2 (en) | 2007-01-19 | 2010-06-15 | Cardiac Pacemakers, Inc. | Ischemia detection using heart sound timing |
US7853327B2 (en) * | 2007-04-17 | 2010-12-14 | Cardiac Pacemakers, Inc. | Heart sound tracking system and method |
US8825161B1 (en) | 2007-05-17 | 2014-09-02 | Cardiac Pacemakers, Inc. | Acoustic transducer for an implantable medical device |
WO2008156981A2 (en) | 2007-06-14 | 2008-12-24 | Cardiac Pacemakers, Inc. | Multi-element acoustic recharging system |
US7731658B2 (en) * | 2007-08-16 | 2010-06-08 | Cardiac Pacemakers, Inc. | Glycemic control monitoring using implantable medical device |
US8412323B2 (en) | 2008-01-29 | 2013-04-02 | Inovise Medical, Inc. | Rest phase heart pacing |
US8348852B2 (en) | 2008-03-06 | 2013-01-08 | Inovise Medical, Inc. | Heart-activity sound monitoring |
WO2011008748A2 (en) | 2009-07-15 | 2011-01-20 | Cardiac Pacemakers, Inc. | Remote pace detection in an implantable medical device |
EP2453977B1 (en) * | 2009-07-15 | 2017-11-08 | Cardiac Pacemakers, Inc. | Physiological vibration detection in an implanted medical device |
EP2453975B1 (en) | 2009-07-15 | 2016-11-02 | Cardiac Pacemakers, Inc. | Remote sensing in an implantable medical device |
US20110066041A1 (en) * | 2009-09-15 | 2011-03-17 | Texas Instruments Incorporated | Motion/activity, heart-rate and respiration from a single chest-worn sensor, circuits, devices, processes and systems |
US8409108B2 (en) | 2009-11-05 | 2013-04-02 | Inovise Medical, Inc. | Multi-axial heart sounds and murmur detection for hemodynamic-condition assessment |
US8548585B2 (en) | 2009-12-08 | 2013-10-01 | Cardiac Pacemakers, Inc. | Concurrent therapy detection in implantable medical devices |
JP5742340B2 (en) * | 2011-03-18 | 2015-07-01 | ソニー株式会社 | Mastication detection device and mastication detection method |
US20130060150A1 (en) | 2011-09-01 | 2013-03-07 | Zhendong Song | Method and apparatus for monitoring cardiac and respiratory conditions using acoustic sounds |
US9675315B2 (en) * | 2012-04-27 | 2017-06-13 | Medtronic, Inc. | Method and apparatus for cardiac function monitoring |
US9138199B2 (en) | 2012-12-03 | 2015-09-22 | Cardiac Pacemakers, Inc. | Method and apparatus for detecting subaudible cardiac vibrations |
TWI546052B (en) * | 2013-11-14 | 2016-08-21 | 財團法人工業技術研究院 | Apparatus based on image for detecting heart rate activity and method thereof |
US9399140B2 (en) | 2014-07-25 | 2016-07-26 | Medtronic, Inc. | Atrial contraction detection by a ventricular leadless pacing device for atrio-synchronous ventricular pacing |
US9789318B2 (en) | 2014-10-17 | 2017-10-17 | Cardiac Pacemakers, Inc. | Method and apparatus for optimizing multi-site pacing using heart sounds |
US9789320B2 (en) | 2014-10-17 | 2017-10-17 | Cardiac Pacemakers, Inc. | Method and apparatus for ambulatory optimization of multi-site pacing using heart sounds |
US10463295B2 (en) * | 2016-06-13 | 2019-11-05 | Medtronic, Inc. | Multi-parameter prediction of acute cardiac episodes and attacks |
US11207527B2 (en) | 2016-07-06 | 2021-12-28 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
TW201705557A (en) * | 2016-10-26 | 2017-02-01 | Liquidleds Lighting Corp | LED filament having heat sink structure and LED bulb using the LED filament characterized in that electricity-conductive carrying elements of the LED filament are exposed outside a packaging layer, so as to allow LED chips to dissipate heat to the outside |
WO2019071050A2 (en) | 2017-10-04 | 2019-04-11 | Ausculsciences, Inc. | Auscultatory sound-or-vibration sensor |
US11284827B2 (en) | 2017-10-21 | 2022-03-29 | Ausculsciences, Inc. | Medical decision support system |
US11529102B2 (en) | 2019-12-02 | 2022-12-20 | Analog Devices, Inc. | Heart sound normalization |
Citations (78)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4220160A (en) | 1978-07-05 | 1980-09-02 | Clinical Systems Associates, Inc. | Method and apparatus for discrimination and detection of heart sounds |
US4428380A (en) | 1980-09-11 | 1984-01-31 | Hughes Aircraft Company | Method and improved apparatus for analyzing activity |
US4586514A (en) | 1983-08-10 | 1986-05-06 | Biotronics Instruments | Phonoangiographic spectral analysing apparatus |
US4628939A (en) | 1980-09-11 | 1986-12-16 | Hughes Aircraft Company | Method and improved apparatus for analyzing heart activity |
US4702253A (en) | 1985-10-15 | 1987-10-27 | Telectronics N.V. | Metabolic-demand pacemaker and method of using the same to determine minute volume |
US4796639A (en) | 1987-11-05 | 1989-01-10 | Medical Graphics Corporation | Pulmonary diagnostic system |
US4905706A (en) | 1988-04-20 | 1990-03-06 | Nippon Colin Co., Ltd. | Method an apparatus for detection of heart disease |
US4967760A (en) | 1989-02-02 | 1990-11-06 | Bennett Jr William R | Dynamic spectral phonocardiograph |
US4981139A (en) | 1983-08-11 | 1991-01-01 | Pfohl Robert L | Vital signs monitoring and communication system |
US5010889A (en) | 1988-02-04 | 1991-04-30 | Bloodline Technology | Intelligent stethoscope |
US5025809A (en) | 1989-11-28 | 1991-06-25 | Cardionics, Inc. | Recording, digital stethoscope for identifying PCG signatures |
US5179947A (en) | 1991-01-15 | 1993-01-19 | Cardiac Pacemakers, Inc. | Acceleration-sensitive cardiac pacemaker and method of operation |
US5218969A (en) | 1988-02-04 | 1993-06-15 | Blood Line Technology, Inc. | Intelligent stethoscope |
US5301679A (en) | 1991-05-31 | 1994-04-12 | Taylor Microtechnology, Inc. | Method and system for analysis of body sounds |
US5337752A (en) | 1992-05-21 | 1994-08-16 | Mcg International, Inc. | System for simultaneously producing and synchronizing spectral patterns of heart sounds and an ECG signal |
US5544661A (en) | 1994-01-13 | 1996-08-13 | Charles L. Davis | Real time ambulatory patient monitor |
US5554177A (en) | 1995-03-27 | 1996-09-10 | Medtronic, Inc. | Method and apparatus to optimize pacing based on intensity of acoustic signal |
US5674256A (en) | 1995-12-19 | 1997-10-07 | Cardiac Pacemakers, Inc. | Cardiac pre-ejection period detection |
US5687738A (en) | 1995-07-03 | 1997-11-18 | The Regents Of The University Of Colorado | Apparatus and methods for analyzing heart sounds |
US5700283A (en) | 1996-11-25 | 1997-12-23 | Cardiac Pacemakers, Inc. | Method and apparatus for pacing patients with severe congestive heart failure |
US5792195A (en) | 1996-12-16 | 1998-08-11 | Cardiac Pacemakers, Inc. | Acceleration sensed safe upper rate envelope for calculating the hemodynamic upper rate limit for a rate adaptive cardiac rhythm management device |
US5836987A (en) | 1995-11-15 | 1998-11-17 | Cardiac Pacemakers, Inc. | Apparatus and method for optimizing cardiac performance by determining the optimal timing interval from an accelerometer signal |
US5860933A (en) | 1997-04-04 | 1999-01-19 | Don Michael; T. Anthony | Apparatus for aiding in the diagnosis of heart conditions |
US5935081A (en) | 1998-01-20 | 1999-08-10 | Cardiac Pacemakers, Inc. | Long term monitoring of acceleration signals for optimization of pacing therapy |
US6002777A (en) | 1995-07-21 | 1999-12-14 | Stethtech Corporation | Electronic stethoscope |
US6044298A (en) | 1998-10-13 | 2000-03-28 | Cardiac Pacemakers, Inc. | Optimization of pacing parameters based on measurement of integrated acoustic noise |
US6044299A (en) | 1996-09-30 | 2000-03-28 | Pacesetter Ab | Implantable medical device having an accelerometer |
US6144880A (en) | 1998-05-08 | 2000-11-07 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6193668B1 (en) | 1997-11-10 | 2001-02-27 | Medacoustics, Inc. | Acoustic sensor array for non-invasive detection of coronary artery disease |
US6208900B1 (en) | 1996-03-28 | 2001-03-27 | Medtronic, Inc. | Method and apparatus for rate-responsive cardiac pacing using header mounted pressure wave transducer |
US6269396B1 (en) | 1997-12-12 | 2001-07-31 | Alcatel Usa Sourcing, L.P. | Method and platform for interfacing between application programs performing telecommunications functions and an operating system |
WO2001056651A1 (en) | 2000-02-02 | 2001-08-09 | Cardiac Pacemakers, Inc. | Accelerometer-based heart sound detection for autocapture |
US6327622B1 (en) | 1998-09-03 | 2001-12-04 | Sun Microsystems, Inc. | Load balancing in a network environment |
US20020001390A1 (en) | 2000-02-18 | 2002-01-03 | Colin Corporation | Heart-sound detecting apparatus, system for measuring pre-ejection period by using heart-sound detecting apparatus, and system for obtaining pulse-wave-propagation-velocity-relating information by using heart-sound detecting apparatus |
US20020035337A1 (en) | 2000-08-09 | 2002-03-21 | Colin Corporation | Heart-sound analyzing apparatus |
US20020072684A1 (en) | 1998-11-09 | 2002-06-13 | Stearns Scott Donaldson | Acoustic window identification |
US6411840B1 (en) | 1999-11-16 | 2002-06-25 | Cardiac Intelligence Corporation | Automated collection and analysis patient care system and method for diagnosing and monitoring the outcomes of atrial fibrillation |
US6409675B1 (en) | 1999-11-10 | 2002-06-25 | Pacesetter, Inc. | Extravascular hemodynamic monitor |
US6440082B1 (en) * | 1999-09-30 | 2002-08-27 | Medtronic Physio-Control Manufacturing Corp. | Method and apparatus for using heart sounds to determine the presence of a pulse |
US6459929B1 (en) | 1999-11-04 | 2002-10-01 | Cardiac Pacemakers, Inc. | Implantable cardiac rhythm management device for assessing status of CHF patients |
US20020147401A1 (en) | 2001-04-04 | 2002-10-10 | Colin Corporation | Continuous blood-pressure monitoring apparatus |
US20020151938A1 (en) | 2000-11-17 | 2002-10-17 | Giorgio Corbucci | Myocardial performance assessment |
US6477406B1 (en) | 1999-11-10 | 2002-11-05 | Pacesetter, Inc. | Extravascular hemodynamic acoustic sensor |
US6480733B1 (en) | 1999-11-10 | 2002-11-12 | Pacesetter, Inc. | Method for monitoring heart failure |
US6491639B1 (en) | 1999-11-10 | 2002-12-10 | Pacesetter, Inc. | Extravascular hemodynamic sensor |
US6520924B2 (en) | 2000-11-16 | 2003-02-18 | Byung Hoon Lee | Automatic diagnostic apparatus with a stethoscope |
US6527729B1 (en) | 1999-11-10 | 2003-03-04 | Pacesetter, Inc. | Method for monitoring patient using acoustic sensor |
US20030060851A1 (en) | 2001-09-27 | 2003-03-27 | Cardiac Pacemakers, Inc. | Trending of conduction time for optimization of cardiac resynchronization therapy in cardiac rhythm management system |
US20030092975A1 (en) | 1999-03-08 | 2003-05-15 | Casscells Samuel Ward | Temperature monitoring of congestive heart failure patients as an indicator of worsening condition |
US6575916B2 (en) | 2000-03-24 | 2003-06-10 | Ilife Solutions, Inc. | Apparatus and method for detecting very low frequency acoustic signals |
US20030120159A1 (en) | 1996-12-18 | 2003-06-26 | Mohler Sailor H. | System and method of detecting and processing physiological sounds |
US20030144702A1 (en) | 1998-05-08 | 2003-07-31 | Yinghong Yu | Method and apparatus for optimizing stroke volume during DDD resynchronization therapy using adjustable atrio-ventricular delays |
US20030144703A1 (en) | 1998-05-08 | 2003-07-31 | Yinghong Yu | Method and apparatus for optimizing ventricular synchrony during DDD resynchronization therapy using adjustable atrio-ventricular delays |
US20030176896A1 (en) | 2002-03-13 | 2003-09-18 | Lincoln William C. | Cardiac rhythm management system and method using time between mitral valve closure and aortic ejection |
US6643548B1 (en) | 2000-04-06 | 2003-11-04 | Pacesetter, Inc. | Implantable cardiac stimulation device for monitoring heart sounds to detect progression and regression of heart disease and method thereof |
US20030208240A1 (en) | 2002-05-03 | 2003-11-06 | Pastore Joseph M. | Method and apparatus for detecting acoustic oscillations in cardiac rhythm |
US20030216620A1 (en) | 2002-05-15 | 2003-11-20 | Mudit Jain | Cardiac rhythm management systems and methods using acoustic contractility indicator |
US20030229289A1 (en) | 2002-03-18 | 2003-12-11 | Mohler Sailor Hampton | Method and system for generating a likelihood of cardiovascular disease, analyzing cardiovascular sound signals remotely from the location of cardiovascular sound signal acquisition, and determining time and phase information from cardiovascular sound signals |
US20030233132A1 (en) | 2002-06-14 | 2003-12-18 | Pastore Joseph M. | Method and apparatus for detecting oscillations in cardiac rhythm |
US6733464B2 (en) | 2002-08-23 | 2004-05-11 | Hewlett-Packard Development Company, L.P. | Multi-function sensor device and methods for its use |
US20040106961A1 (en) | 2002-12-02 | 2004-06-03 | Siejko Krzysztof Z. | Method and apparatus for phonocardiographic image acquisition and presentation |
US20040106960A1 (en) | 2002-12-02 | 2004-06-03 | Siejko Krzysztof Z. | Phonocardiographic image-based atrioventricular delay optimization |
WO2004050178A1 (en) | 2002-12-04 | 2004-06-17 | Medtronic, Inc. | Method and apparatus for detecting change in intrathoracic electrical impedance |
US20040127792A1 (en) | 2002-12-30 | 2004-07-01 | Siejko Krzysztof Z. | Method and apparatus for monitoring of diastolic hemodynamics |
US6824519B2 (en) | 2001-06-20 | 2004-11-30 | Colin Medical Technology Corporation | Heart-sound detecting apparatus |
US20040267147A1 (en) | 2001-01-25 | 2004-12-30 | Sullivan Colin Edward | Determining heart rate |
US20040267148A1 (en) | 2003-06-27 | 2004-12-30 | Patricia Arand | Method and system for detection of heart sounds |
US20050059897A1 (en) | 2003-09-17 | 2005-03-17 | Snell Jeffery D. | Statistical analysis for implantable cardiac devices |
US20050065448A1 (en) | 2003-09-18 | 2005-03-24 | Cardiac Pacemakers, Inc. | Methods and systems for assessing pulmonary disease |
US20050149136A1 (en) | 2003-12-24 | 2005-07-07 | Siejko Krzysztof Z. | Third heart sound activity index for heart failure monitoring |
US20060020295A1 (en) | 2004-07-23 | 2006-01-26 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US20060030892A1 (en) | 2004-08-09 | 2006-02-09 | Veerichetty Kadhiresan | Cardiopulmonary functional status assessment via heart rate response dectection by implantable cardiac device |
US7139609B1 (en) * | 2003-01-17 | 2006-11-21 | Pacesetter, Inc. | System and method for monitoring cardiac function via cardiac sounds using an implantable cardiac stimulation device |
US20060282000A1 (en) | 2005-06-08 | 2006-12-14 | Cardiac Pacemakers, Inc. | Ischemia detection using a heart sound sensor |
US20070213599A1 (en) | 2006-03-13 | 2007-09-13 | Siejko Krzysztof Z | Physiological event detection systems and methods |
US7399277B2 (en) | 2001-12-27 | 2008-07-15 | Medtronic Minimed, Inc. | System for monitoring physiological characteristics |
US7431699B2 (en) * | 2003-12-24 | 2008-10-07 | Cardiac Pacemakers, Inc. | Method and apparatus for third heart sound detection |
US7853327B2 (en) | 2007-04-17 | 2010-12-14 | Cardiac Pacemakers, Inc. | Heart sound tracking system and method |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3799147A (en) * | 1972-03-23 | 1974-03-26 | Directors University Cincinnat | Method and apparatus for diagnosing myocardial infarction in human heart |
JP3239501B2 (en) * | 1992-12-22 | 2001-12-17 | ソニー株式会社 | Viterbi decoding method and decoding device |
US8391989B2 (en) * | 2002-12-18 | 2013-03-05 | Cardiac Pacemakers, Inc. | Advanced patient management for defining, identifying and using predetermined health-related events |
-
2003
- 2003-12-24 US US10/746,853 patent/US7431699B2/en active Active
-
2008
- 2008-09-16 US US12/283,760 patent/US8317717B2/en active Active
-
2012
- 2012-11-26 US US13/685,170 patent/US8827919B2/en not_active Expired - Lifetime
Patent Citations (97)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4220160A (en) | 1978-07-05 | 1980-09-02 | Clinical Systems Associates, Inc. | Method and apparatus for discrimination and detection of heart sounds |
US4428380A (en) | 1980-09-11 | 1984-01-31 | Hughes Aircraft Company | Method and improved apparatus for analyzing activity |
US4628939A (en) | 1980-09-11 | 1986-12-16 | Hughes Aircraft Company | Method and improved apparatus for analyzing heart activity |
US4586514A (en) | 1983-08-10 | 1986-05-06 | Biotronics Instruments | Phonoangiographic spectral analysing apparatus |
US4981139A (en) | 1983-08-11 | 1991-01-01 | Pfohl Robert L | Vital signs monitoring and communication system |
US4702253A (en) | 1985-10-15 | 1987-10-27 | Telectronics N.V. | Metabolic-demand pacemaker and method of using the same to determine minute volume |
US4796639A (en) | 1987-11-05 | 1989-01-10 | Medical Graphics Corporation | Pulmonary diagnostic system |
US5010889A (en) | 1988-02-04 | 1991-04-30 | Bloodline Technology | Intelligent stethoscope |
US5218969A (en) | 1988-02-04 | 1993-06-15 | Blood Line Technology, Inc. | Intelligent stethoscope |
US4905706A (en) | 1988-04-20 | 1990-03-06 | Nippon Colin Co., Ltd. | Method an apparatus for detection of heart disease |
US4967760A (en) | 1989-02-02 | 1990-11-06 | Bennett Jr William R | Dynamic spectral phonocardiograph |
US5025809A (en) | 1989-11-28 | 1991-06-25 | Cardionics, Inc. | Recording, digital stethoscope for identifying PCG signatures |
US5179947A (en) | 1991-01-15 | 1993-01-19 | Cardiac Pacemakers, Inc. | Acceleration-sensitive cardiac pacemaker and method of operation |
US5301679A (en) | 1991-05-31 | 1994-04-12 | Taylor Microtechnology, Inc. | Method and system for analysis of body sounds |
US5337752A (en) | 1992-05-21 | 1994-08-16 | Mcg International, Inc. | System for simultaneously producing and synchronizing spectral patterns of heart sounds and an ECG signal |
US5544661A (en) | 1994-01-13 | 1996-08-13 | Charles L. Davis | Real time ambulatory patient monitor |
US5554177A (en) | 1995-03-27 | 1996-09-10 | Medtronic, Inc. | Method and apparatus to optimize pacing based on intensity of acoustic signal |
US5687738A (en) | 1995-07-03 | 1997-11-18 | The Regents Of The University Of Colorado | Apparatus and methods for analyzing heart sounds |
US6002777A (en) | 1995-07-21 | 1999-12-14 | Stethtech Corporation | Electronic stethoscope |
US5836987A (en) | 1995-11-15 | 1998-11-17 | Cardiac Pacemakers, Inc. | Apparatus and method for optimizing cardiac performance by determining the optimal timing interval from an accelerometer signal |
US5674256A (en) | 1995-12-19 | 1997-10-07 | Cardiac Pacemakers, Inc. | Cardiac pre-ejection period detection |
US6208900B1 (en) | 1996-03-28 | 2001-03-27 | Medtronic, Inc. | Method and apparatus for rate-responsive cardiac pacing using header mounted pressure wave transducer |
US6044299A (en) | 1996-09-30 | 2000-03-28 | Pacesetter Ab | Implantable medical device having an accelerometer |
US5700283A (en) | 1996-11-25 | 1997-12-23 | Cardiac Pacemakers, Inc. | Method and apparatus for pacing patients with severe congestive heart failure |
US5792195A (en) | 1996-12-16 | 1998-08-11 | Cardiac Pacemakers, Inc. | Acceleration sensed safe upper rate envelope for calculating the hemodynamic upper rate limit for a rate adaptive cardiac rhythm management device |
US20030120159A1 (en) | 1996-12-18 | 2003-06-26 | Mohler Sailor H. | System and method of detecting and processing physiological sounds |
US5860933A (en) | 1997-04-04 | 1999-01-19 | Don Michael; T. Anthony | Apparatus for aiding in the diagnosis of heart conditions |
US6193668B1 (en) | 1997-11-10 | 2001-02-27 | Medacoustics, Inc. | Acoustic sensor array for non-invasive detection of coronary artery disease |
US6269396B1 (en) | 1997-12-12 | 2001-07-31 | Alcatel Usa Sourcing, L.P. | Method and platform for interfacing between application programs performing telecommunications functions and an operating system |
US5935081A (en) | 1998-01-20 | 1999-08-10 | Cardiac Pacemakers, Inc. | Long term monitoring of acceleration signals for optimization of pacing therapy |
US6351673B1 (en) | 1998-05-08 | 2002-02-26 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US20030144703A1 (en) | 1998-05-08 | 2003-07-31 | Yinghong Yu | Method and apparatus for optimizing ventricular synchrony during DDD resynchronization therapy using adjustable atrio-ventricular delays |
US6542775B2 (en) | 1998-05-08 | 2003-04-01 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6144880A (en) | 1998-05-08 | 2000-11-07 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6684103B2 (en) | 1998-05-08 | 2004-01-27 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US20030144702A1 (en) | 1998-05-08 | 2003-07-31 | Yinghong Yu | Method and apparatus for optimizing stroke volume during DDD resynchronization therapy using adjustable atrio-ventricular delays |
US6360127B1 (en) | 1998-05-08 | 2002-03-19 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6327622B1 (en) | 1998-09-03 | 2001-12-04 | Sun Microsystems, Inc. | Load balancing in a network environment |
US6044298A (en) | 1998-10-13 | 2000-03-28 | Cardiac Pacemakers, Inc. | Optimization of pacing parameters based on measurement of integrated acoustic noise |
US6058329A (en) | 1998-10-13 | 2000-05-02 | Cardiac Pacemakers, Inc. | Optimization of pacing parameters based on measurement of acoustic noise |
US20020072684A1 (en) | 1998-11-09 | 2002-06-13 | Stearns Scott Donaldson | Acoustic window identification |
US6478746B2 (en) | 1998-11-09 | 2002-11-12 | Medacoustics, Inc. | Acoustic sensor array for non-invasive detection of coronary artery disease |
US20030092975A1 (en) | 1999-03-08 | 2003-05-15 | Casscells Samuel Ward | Temperature monitoring of congestive heart failure patients as an indicator of worsening condition |
US6821249B2 (en) | 1999-03-08 | 2004-11-23 | Board Of Regents, The University Of Texas | Temperature monitoring of congestive heart failure patients as an indicator of worsening condition |
US6440082B1 (en) * | 1999-09-30 | 2002-08-27 | Medtronic Physio-Control Manufacturing Corp. | Method and apparatus for using heart sounds to determine the presence of a pulse |
US6459929B1 (en) | 1999-11-04 | 2002-10-01 | Cardiac Pacemakers, Inc. | Implantable cardiac rhythm management device for assessing status of CHF patients |
US6491639B1 (en) | 1999-11-10 | 2002-12-10 | Pacesetter, Inc. | Extravascular hemodynamic sensor |
US6477406B1 (en) | 1999-11-10 | 2002-11-05 | Pacesetter, Inc. | Extravascular hemodynamic acoustic sensor |
US6527729B1 (en) | 1999-11-10 | 2003-03-04 | Pacesetter, Inc. | Method for monitoring patient using acoustic sensor |
US6480733B1 (en) | 1999-11-10 | 2002-11-12 | Pacesetter, Inc. | Method for monitoring heart failure |
US6409675B1 (en) | 1999-11-10 | 2002-06-25 | Pacesetter, Inc. | Extravascular hemodynamic monitor |
US6411840B1 (en) | 1999-11-16 | 2002-06-25 | Cardiac Intelligence Corporation | Automated collection and analysis patient care system and method for diagnosing and monitoring the outcomes of atrial fibrillation |
WO2001056651A1 (en) | 2000-02-02 | 2001-08-09 | Cardiac Pacemakers, Inc. | Accelerometer-based heart sound detection for autocapture |
US20020001390A1 (en) | 2000-02-18 | 2002-01-03 | Colin Corporation | Heart-sound detecting apparatus, system for measuring pre-ejection period by using heart-sound detecting apparatus, and system for obtaining pulse-wave-propagation-velocity-relating information by using heart-sound detecting apparatus |
US6575916B2 (en) | 2000-03-24 | 2003-06-10 | Ilife Solutions, Inc. | Apparatus and method for detecting very low frequency acoustic signals |
US6643548B1 (en) | 2000-04-06 | 2003-11-04 | Pacesetter, Inc. | Implantable cardiac stimulation device for monitoring heart sounds to detect progression and regression of heart disease and method thereof |
US6626842B2 (en) | 2000-08-09 | 2003-09-30 | Colin Corporation | Heart-sound analyzing apparatus |
US20020035337A1 (en) | 2000-08-09 | 2002-03-21 | Colin Corporation | Heart-sound analyzing apparatus |
US6520924B2 (en) | 2000-11-16 | 2003-02-18 | Byung Hoon Lee | Automatic diagnostic apparatus with a stethoscope |
US20020151938A1 (en) | 2000-11-17 | 2002-10-17 | Giorgio Corbucci | Myocardial performance assessment |
US6792308B2 (en) | 2000-11-17 | 2004-09-14 | Medtronic, Inc. | Myocardial performance assessment |
US20040267147A1 (en) | 2001-01-25 | 2004-12-30 | Sullivan Colin Edward | Determining heart rate |
US20020147401A1 (en) | 2001-04-04 | 2002-10-10 | Colin Corporation | Continuous blood-pressure monitoring apparatus |
US6824519B2 (en) | 2001-06-20 | 2004-11-30 | Colin Medical Technology Corporation | Heart-sound detecting apparatus |
US20030060851A1 (en) | 2001-09-27 | 2003-03-27 | Cardiac Pacemakers, Inc. | Trending of conduction time for optimization of cardiac resynchronization therapy in cardiac rhythm management system |
US7399277B2 (en) | 2001-12-27 | 2008-07-15 | Medtronic Minimed, Inc. | System for monitoring physiological characteristics |
US20030176896A1 (en) | 2002-03-13 | 2003-09-18 | Lincoln William C. | Cardiac rhythm management system and method using time between mitral valve closure and aortic ejection |
US20030229289A1 (en) | 2002-03-18 | 2003-12-11 | Mohler Sailor Hampton | Method and system for generating a likelihood of cardiovascular disease, analyzing cardiovascular sound signals remotely from the location of cardiovascular sound signal acquisition, and determining time and phase information from cardiovascular sound signals |
US20030208240A1 (en) | 2002-05-03 | 2003-11-06 | Pastore Joseph M. | Method and apparatus for detecting acoustic oscillations in cardiac rhythm |
US20030216620A1 (en) | 2002-05-15 | 2003-11-20 | Mudit Jain | Cardiac rhythm management systems and methods using acoustic contractility indicator |
US20030233132A1 (en) | 2002-06-14 | 2003-12-18 | Pastore Joseph M. | Method and apparatus for detecting oscillations in cardiac rhythm |
US6733464B2 (en) | 2002-08-23 | 2004-05-11 | Hewlett-Packard Development Company, L.P. | Multi-function sensor device and methods for its use |
US20040106960A1 (en) | 2002-12-02 | 2004-06-03 | Siejko Krzysztof Z. | Phonocardiographic image-based atrioventricular delay optimization |
US20040106961A1 (en) | 2002-12-02 | 2004-06-03 | Siejko Krzysztof Z. | Method and apparatus for phonocardiographic image acquisition and presentation |
WO2004050178A1 (en) | 2002-12-04 | 2004-06-17 | Medtronic, Inc. | Method and apparatus for detecting change in intrathoracic electrical impedance |
US20040127792A1 (en) | 2002-12-30 | 2004-07-01 | Siejko Krzysztof Z. | Method and apparatus for monitoring of diastolic hemodynamics |
WO2004060483A1 (en) | 2002-12-30 | 2004-07-22 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring of diastolic hemodynamics |
US7139609B1 (en) * | 2003-01-17 | 2006-11-21 | Pacesetter, Inc. | System and method for monitoring cardiac function via cardiac sounds using an implantable cardiac stimulation device |
US20040267148A1 (en) | 2003-06-27 | 2004-12-30 | Patricia Arand | Method and system for detection of heart sounds |
US7096060B2 (en) | 2003-06-27 | 2006-08-22 | Innovise Medical, Inc. | Method and system for detection of heart sounds |
US20050059897A1 (en) | 2003-09-17 | 2005-03-17 | Snell Jeffery D. | Statistical analysis for implantable cardiac devices |
US20050065448A1 (en) | 2003-09-18 | 2005-03-24 | Cardiac Pacemakers, Inc. | Methods and systems for assessing pulmonary disease |
US20070078491A1 (en) | 2003-12-24 | 2007-04-05 | Cardiac Pacemakers, Inc. | Third heart sound activity index for heart failure monitoring |
US20050149136A1 (en) | 2003-12-24 | 2005-07-07 | Siejko Krzysztof Z. | Third heart sound activity index for heart failure monitoring |
US7431699B2 (en) * | 2003-12-24 | 2008-10-07 | Cardiac Pacemakers, Inc. | Method and apparatus for third heart sound detection |
US20090132000A1 (en) | 2004-07-23 | 2009-05-21 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
WO2006028575A2 (en) | 2004-07-23 | 2006-03-16 | Cardiac Pacemakers, Inc. | Method and apparatus for detecting cardiopulmonary comorbidities |
US7480528B2 (en) | 2004-07-23 | 2009-01-20 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US20060020295A1 (en) | 2004-07-23 | 2006-01-26 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US8065010B2 (en) | 2004-07-23 | 2011-11-22 | Cardiac Pacemakers, Inc. | Method and apparatus for monitoring heart failure patients with cardiopulmonary comorbidities |
US20060030892A1 (en) | 2004-08-09 | 2006-02-09 | Veerichetty Kadhiresan | Cardiopulmonary functional status assessment via heart rate response dectection by implantable cardiac device |
US20060282000A1 (en) | 2005-06-08 | 2006-12-14 | Cardiac Pacemakers, Inc. | Ischemia detection using a heart sound sensor |
US20070213599A1 (en) | 2006-03-13 | 2007-09-13 | Siejko Krzysztof Z | Physiological event detection systems and methods |
US7713213B2 (en) | 2006-03-13 | 2010-05-11 | Cardiac Pacemakers, Inc. | Physiological event detection systems and methods |
US20100222653A1 (en) | 2006-03-13 | 2010-09-02 | Siejko Krzysztof Z | Physiological event detection systems and methods |
US7853327B2 (en) | 2007-04-17 | 2010-12-14 | Cardiac Pacemakers, Inc. | Heart sound tracking system and method |
US20110077543A1 (en) | 2007-04-17 | 2011-03-31 | Abhilash Patangay | Heart sound tracking system and method |
Non-Patent Citations (45)
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20130085407A1 (en) * | 2003-12-24 | 2013-04-04 | Krzysztof Z. Siejko | Method and apparatus for third heart sound detection |
US8827919B2 (en) * | 2003-12-24 | 2014-09-09 | Cardiac Pacemakers, Inc. | Method and apparatus for third heart sound detection |
US9968266B2 (en) | 2006-12-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Risk stratification based heart failure detection algorithm |
US20140031643A1 (en) * | 2012-07-27 | 2014-01-30 | Cardiac Pacemakers, Inc. | Heart failure patients stratification |
US10405826B2 (en) | 2015-01-02 | 2019-09-10 | Cardiac Pacemakers, Inc. | Methods and system for tracking heart sounds |
US10123745B1 (en) | 2015-08-21 | 2018-11-13 | Greatbatch Ltd. | Apparatus and method for cardiac signal noise detection and disposition based on physiologic relevance |
US11179109B1 (en) | 2015-08-21 | 2021-11-23 | Greatbatch Ltd. | Apparatus and method for cardiac signal noise detection and disposition based on physiologic relevance |
US11615891B2 (en) | 2017-04-29 | 2023-03-28 | Cardiac Pacemakers, Inc. | Heart failure event rate assessment |
Also Published As
Publication number | Publication date |
---|---|
US20090018461A1 (en) | 2009-01-15 |
US8827919B2 (en) | 2014-09-09 |
US20130085407A1 (en) | 2013-04-04 |
US7431699B2 (en) | 2008-10-07 |
US20050148896A1 (en) | 2005-07-07 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8827919B2 (en) | Method and apparatus for third heart sound detection | |
US9668713B2 (en) | Third heart sound activity index for heart failure monitoring | |
US7972275B2 (en) | Method and apparatus for monitoring of diastolic hemodynamics | |
EP2704795B1 (en) | Verification of pressure metrics | |
EP3148442B1 (en) | Apparatus for detecting atrial tachyarrhythmia using heart sounds | |
EP1962954B1 (en) | Implantable medical device with therapy control | |
EP1957161B1 (en) | Implantable medical device with therapy control | |
US20150126886A1 (en) | Method and apparatus for detecting atrial filling pressure |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
FEPP | Fee payment procedure |
Free format text: PAYOR NUMBER ASSIGNED (ORIGINAL EVENT CODE: ASPN); ENTITY STATUS OF PATENT OWNER: LARGE ENTITY |
|
STCF | Information on status: patent grant |
Free format text: PATENTED CASE |
|
FPAY | Fee payment |
Year of fee payment: 4 |
|
MAFP | Maintenance fee payment |
Free format text: PAYMENT OF MAINTENANCE FEE, 8TH YEAR, LARGE ENTITY (ORIGINAL EVENT CODE: M1552); ENTITY STATUS OF PATENT OWNER: LARGE ENTITY Year of fee payment: 8 |